10 August 2008

Helmets or Health?

Rush hour in Copenhagen.For those who follow this blog it can hardly be a secret that we firmly believe that bicycle helmets should be a private matter and a personal choice - and that helmet promotion and legislation are the greatest threats to bicycle culture since the dawn of the automobile age.

I had a discussion the other day with a friend from England regarding our campaign against helmet promotion here in Denmark on Cykelhjelm.org. We agreed that it's a weighty task and the message is a challenge to get across. There's all the science about what protection a helmet actually provides and then there's the whole societal issue about the effects of helmet promotion.

We ended up agreeing on what the issue is all about. Our society here - and elsewhere - has a simple and important choice:

What do we want for society as a whole?A. More people in bike helmets?B. More people on bikes?

You can't have both as common sense and the existing data will suggest.

For me B. is the obvious choice. The health and societal benefits are far greater when more people get onto bikes. A fall in illnesses like diabetes, heart disease and certain forms of cancer, a fall in obesity and a rise in productivity and life expectancy. Good for society.

What do you choose? One answer only, please.

One of the perks of having this blog is that I've made the acquaintence of many bicycle advocates from around the world. Either visiting Copenhagen to research our bike culture or through ongoing email conversations. Advocates, urban planners, policy makers in transport departments, municipal officals, bike organisations, what have you, from all over the world. It's amazing to exchange views and experiences.

Many of you know how touchy the helmet debate can be. This was underlined for me the other day. I've had a pleasant, extended email conversation with a municipal offical in a medium-sized American city that is making an effort to plant the seeds of bike culture. It was, for ages, a fine and good exchange punctuated with enthusiasm and good karma.

It all changed rather rapidly when I started blogging more about helmet promotion and helmets. I recieved a 'Dear John' email stating that our 'relationship' was over. Ridiculous and childish, yes. It was cause to roll my eyes and sigh, but nothing more than that. Helmets had come between us and my opinions about them were too much for this policy maker.

It made me wonder about the differences between helmet advocates and bicycle advocates. You'd think they were one in the same but I don't reckon they are. Here's why:

- Helmet advocates sell helmets and fear is their greatest marketing tool.And legislators who vote for helmet laws sell helmets through a sad cocktail of ignorance and 'passing the buck' - exposing their own inability and unwillingness to develop safe infrastructure for bicycles.

- Bicycle advocates, on the other hand, sell urban cycling and they do so for the greater good. And they use science to sell their wares. Period.

So if you meet a 'bicycle advocate' who starts waffling on about helmets - run. Or rather ride away.

I know, I know. Things are different here in Europe. We have 100 million daily cyclists and very, very few wear helmets. We do have vocal political bodies and organisations like the EU, the WHO and the European Cyclists' Federation who all warn against helmet promotion and legislation because it effectively kills off bicycle culture and because the health and societal benefits of people cycling are much more important.

Once again. Choose A. or choose B. As above.

Now that Australia has become the fattest nation in the western world [26% of the population are obese - 25% in the USA], the country's destructive helmet laws are in the spotlight once again. Read more about this here.In addition to gaining a fruitful network of bicycle advocates, starting this helmet research and analysis has put me into contact with a growing number of people who share the same concerns. Information and experience is exchanged, research studies that can be difficult to obtain are made available. Words of encouragement fly electronically across borders and seas.

One kindred spirit emailed this interesting point: For every one life 'allegedly' saved by a bike helmet on a bike we could save 20 lives of motorists and passengers if they, too wore the helmets. And don't forget the pedestrians.

Come on people!!! Don't we want to save lives!!?? And where are the helmet manufacturers on this issue? Think how many helmets they could sell!

Alas, if only helmet advocates were equipped with logic and science. I read the other day 37,000 people drown each year in Europe. A helmet is not an effective piece of equipment for saving lives but a lifevest most certainly is.

85 comments:

B! Thank you so much for actually saying what so many of us are thinking. Where I live (TX, USA), people are horrified by the fact that I ride my bicycle on the street. When they find out that I don't wear a helmet, they think I have some sort of death wish. Everyone has been taught to fear riding on the street, so they do one of two things. 1) Never touch a bicycle again or 2) Put on their spandex and helmets, put their bike on a rack on their car, and drive across town to the nearest bike path to ride around in circles...ugh.

Thankfully, the helmet laws aren't really enforced because the police have more important things to do.

Up until two weeks ago, I wouldn't have questioned ticking the box by choice B -- I personally ride on the streets without a helmet and have never felt unsafe. Then I witnessed a bicycle accident on the West Side bike path in NYC, and played my good Samaritan role with first aid until the paramedics arrived, seeing it all very first hand.

This was not an accident from carelessness, nor one involving inexperienced riders -- two daily cyclists, one clearly exercising (in spandex and helmet) was bumped by the second, on his way to the greenmarket (in everyday clothes on a cruiser with basket, also wearing a helmet). While riding fairly slowly 25 yards down from an intersection, Mr. Everyday wobbled slightly while moving left to avoid a jogger, and bumped the tire of Mr. Exercise -- he tumbled over the handlebars and his bike landed on top of him - banging him up pretty badly and knocking him unconscious. Mr. Everyday's injuries were all minor, but I shudder to think what would have happened if he hadn't been wearing a helmet. His head bounced when it the pavement, and the pedal of his bike hit his helmet just at the temple when his bike landed.

The helmet laws in my town are pretty clear -- children under 16 must wear helmets (which I think is sensible), and adults have the option to do so or not for everyday cycling. Extreme sports complexes require helmets and joint pads, which again is only sensible. But

My libertarian principles keep my opinion on the side of personal choice as being where it's at, but I can now better appreciate where those arguing for forced compliance are coming from - considering the Public Health consequences.

I shudder to think, but I've also witnessed a dangerous situation with expensive public health consequences partially prevented. And, unfortunately for all of us who work off of evidence-based strategies, anecdotal evidence is more powerful for many people than any scientific report -- particularly when so much conflicting "evidence" is presented by all sides (and you've complained of false stats provided by the other side often enough here for me to look them up a few times!).

I understand quite well what the evidence states, both in terms of how laws affect a populace's opinion about an activity and in terms of how much safer we actually are (or aren't) when taking safety precautions. The problem is that most people don't take the time to do so, some policy makers included. Therefore, those of us who do advocate for cycling safely as fully participatory members in a transportation environment have far more work to do than merely saying "helmet laws discourage people from cycling" and point toward scientific reports that back up the statement. Personally, I'm looking forward to engaging in that work -- and not just the debate -- when I move to my new home-city with it's fresh, new bike lane.

The options are:a) Less people riding bikes without helmetsb) More people riding bikes.

There are two ways to achieve (a). The first is what helmet advocates promote:a1) Less {people riding bikes} without helmets.That is, assuming the number of people riding bikes remains constant, reduce the number of them with bare heads.

The second is what helmet detractors fear:a2) Less {people riding bikes without helmets}.That is, an overall reduction in the number of people who ride bikes, by eliminating those who would choose not to wear a helmet.

Here in Australia we've had our helmet laws for many years now. I was an early teenager when they were introduced, so I don't remember the implications at the time. It became the law, so my parents bought me a helmet and told me I had to wear it. I was a (1a) case, because the mobility afforded me by my bike was essential to me. I would have (begrudgingly) ridden in a gorilla suit if my parents had insisted.

I believe the long-term effects on cycling in Australia as been a mixture of the two. Many people cycle, and helmet use is almost universal. But there are many more who don't cycle, and helmets are one of the obstructions.

For some, it's explicit - "I can't ride a bike because a helmet would mess up my hair". Uncomfortable. Hot. Look like a dork. General inconvenience.

For many more, it's less so. As Zakkaliciousness alludes, helmet law has fed a public perception that cycling must be dangerous. That perception may have happened anyway (we're becoming a much more fearful and conservative society in general), but helmet laws and the universal wearing of helmets on bikes does nothing to dispel the belief that cycling is risky.

To the average person, cycling is now a niche recreation requiring specialist equipment - helmet and lycra, probably colour-matched to the bike.

There's a cultural shift toward transport cycling under way, and I'm optimistic that it will blossom in the coming summer. But I don't expect it to immediately become a social norm to (strap on a styrofoam hat and) jump on a bike to ride just a couple of blocks as part of their normal daily business. Some will, but most will continue to drive...

the lack of universal health care in the US is a factor in any helmet hysteria here, I think. I wear a helmet in large part because my health insurance would be insufficient in the unlikely event that I experienced a serious head injury while biking. It's protection against the financial risk as much as any medical one.

Undoubtly there are several situations where a helmet might save cyclists from some kind of head injury. But undoubtly there are even more situations where a helmet might save a car driver from head injury. Or someone playing soccer, tennis, etc. Or someone going down the stairs at home.

The risk of suffering a severe head injury while driving a car, making sports or just keeping the house is statistically much higher than while riding. Don´t believe it? Ask German Hannelore-Kohl-Stiftung, a well-known foundation studying craniocerebral injuries. They are bike helmet advocates, and even they admit that among all activities biking has one of the lowest risks of head injuries. Comparable to walking along the pavement.

Dear helmet advocates, I don´t mind if you wear a bike helmet. I don´t even mind if you force your kids to wear helmets. But please do it as well in your car, on the tennis court and at home. If you don´t I take the liberty to call your behaviour irresponsible.

Thanks for reading and sorry for any mistakes. English is not my native language.

interesting, hhw, about the lack of health care. then the logical path would be city councils encouraging more people to ride, simply because of the Safety in Numbers statistics. More cyclists, less accidents.

speeddemon: Everyone i know rides at night. Can't avoid it here, when the sun sets at 16:00 in the winter. a strange reason to wear a helmet, though.

As a child, (there was no helmet law) I rode my bicycle on many 20 to 50 mile trips across Los Angeles to the Beach and back. I rode on highways with both cars and big trucks (lorries, lastvogns) ... if one of those had hit me, no helmet would have saved me. And there were more people riding bicycles then. And less injuries that would require a helmet. At times I chose to ride back streets where traffic was not an issue.

I have seen one incident and been in one accident where a helmet might or might not have been helpful. 1) some teenagers in a car, threw a glass coca-cola bottle out an open window and hit a bicycle rider ... knocking him over. He got up and rode away. 2) a car waiting to make a turn across traffic ... didn't see anymore cars (I was riding with traffic) ... and never saw me until I was flying off his hood ornament. My neck and head landed on a tall stone curb in such a manner that a helmet would not have protected my life ... but my backpack full of books did. Or my guardian angels were working overtime. I had vertigo for a couple months afterwards ... the same as I would have, wearing a helmet and bounced my head off the ground.

Sometimes now I ride with a helmet ... mostly just to keep my baseball hat/cap from flying off ... otherwise, I don't use one. One child was traumatized by fotos of myself and his mother riding bicycles without helmets.

When I ride down to the food market and go shopping ... what do you do with that darn helmet?? Wear it while you are in the store? Great fashion statement. Leave it outside to get stolen? Have one hand carrying it while you carry the shopping bag or basket in the other hand?

Unless the corporate guys (there's money to be made selling helmets) convince all the politicians that EVERYONE should wear a full-head helmet ALL THE TIME (no beanies, no light-weight plastic safety hats) ... nurses, doctors, teachers, car drivers, construction workers, etc. ... because you never know what could happen ... you might slip on a wet floor and get a concussion ...

It is certainly true that places like Copenhagen and Amsterdam are very different from most other cities in the world, especially cities in the US, but this, of course, is part of the point. Our goal should be to aspire to the more ideal conditions of these cities, to reduce the overall lethality of traffic and make the roads safer for all, rather than to simply accept that we will never be able to change a dangerous situation, and must be required to protect ourselves from it. Traffic is not a force of nature, over which we have no influence. It is us, and we can change it. There has been much talk of "tipping points" lately. The tipping point I am waiting for (here in the US) is the point at which the focus of law enforcement and safety promotion shifts from the most vulnerable to the most harmful road users. That will mark a serious change in the nature of travel. Val

There was yet another piece in the Guardian http://www.guardian.co.uk/lifeandstyle/2008/aug/11/healthandwellbeing.transport today about helmets. Sitting on the fence but at least this is being debated.

After a trip to Denmark last week and taking our two kids cycling in Copenhagen we have come out against them. Life's too dull already,let's feel the wind in our hair!

B. It should be a personal decision - being enforced to wear your helmet is like...having laws mandate on how you should raise your children;(some law in CA tried doing that) perhaps that analogy is a bit of a stretch! As much as we would like for everyone to be safe as possible (I DO wear my bicycle helmet, Berkeley has a safety awareness program and gives out helmets for free!), I believe that strict helmet laws would stifle the ridership. Anyway, more bikers = more safe!

Well, I think that this helmet-discussion is a no-sense. For my point of view, of course. I'm living in Madrid and only a few of us are trying to use the bicycle in this city. There is a culture on sport, on cycling, but not on urban daily biking (going to work, you know). There is no useful bicycle lanes. Cycling near the cars is a quite dangerous activity. Almost in the city nothing is adapted to bikes.

B!Actually Bethany the idea of wearing a helmet in a car makes more sense than wearing one on a bicycle. Most fatalities in car crashes are caused by head injuries. Wouldn't it be funny if everyone had to put on their silly little helmet to go for a ride in their car!Here in Sydney I have to wear a helmet to avoid harassment from the police.

This is just a case where people want to institute a particular law to improve safety.

In the US, if you drive in a car you're not required to wear a helmet, but you are required to wear a seatbelt. It sometimes seems arbitrary what the law mandates us to do in the name of "safety," I guess.

In any case, I'm pretty sure that there's plenty of scientific evidence to support the use of helmets in preventing injury or death. Of course not in every case... But statistically speaking, they help your chances.

Data gathered over 10 years in NYC shows that in 97% of the bicycle fatalities the bicyclists were not wearing helmets. However, they estimate that only 78% of people on bicycles as a whole ride without helmets.

That means that non-helmet-wearing bicyclists were overrepresented in fatalities, when comapred to the population as a whole. Which seemingly implies that wearing a helmet while riding a bicycle helps to prevent death.

I guess you could question other things... Do people who don't wear helmets ride more unsafely in general, for example? I don't know. But the annoyance of wearing a helmet is small when compared to the possible upside benefit of it.

Plus, my helmet is pink!

In any case, I tend towards allowing people to make the personal choice themselves... Whatever that's worth.

Being from Vitoria-Gasteiz in the Basque country (Northern Spain), I can tell you that the vast majority of cyclist here don't use helmets. Cities like San Sebastian and Vitoria are a lot more bike friendly than car crazy Madrid. I think that the feeling of not needing a helmet is a sign of how liveable a city is.

In the Midwest USA, the loudest preachers of helmet use are the appointed leaders of cycling advocacy groups. KC MO has the lowest cycling commuters in the USA and St Louis is not far behind. Of course many of these same advocates believe that infrastructure is unimportant and VC rules.

Jessy: you're 'pretty sure' about some things and you use words like 'seemingly'. Having read the scientific studies and actually researched the details, I am able to say that There is no comprehensive scientific proof that helmets save lives or prevent serious injury. Which is why I post about it.

why does everyone think our heads are so soft? Sure it hurts, but your head can take at least a 30mph impact without injury.

People look at a cracked helmet and go crazy thinking their head would do the same thing - it wont! It's styrofoam people - of course it shatters on impact.

I've fallen off my bike prob. a thousand times since I was a kid, and my head always managed to miss the pavement BECAUSE I WASN'T wearing a helmet. Without it your head is a smaller target, and you dont' have big fins sticking out past the natural lines of your body. I mean how can you do a roll when you hit the ground if you have a big fin stickout out the back of your head? wouldn't it twist your neck? Your head is the size/shape it is for a reason.

People have no faith in the natural anatomy of their boddies, that's the problem. They have more faith in cheap plastic stuff from china.

Regarding health care provision - I don't think we Europeans go out without helmets to get recreational head injuries just because we know the NHS (or whatever) will pick up the tab ... I ride without a helmet because I'm not intending to fall off.

But seriously Zakk, I see your point but I think you should be careful about overdoing the cycle helmet thing. There's a generation in the UK (and probably the US as well) that has grown up wearing helmets, and non-helmet wearers are becoming a real minority (full disclosure: I never wear a helmet for all the arguments given above, but I was a kid in the seventies when we were allowed to try and kill ourselves in all sorts of inventive ways and mostly didn't succeed). For them, not wearing a helmet on a bike would feel as wierd as sitting in the front seat of a car without a seatbelt would for me now - it just wouldn't feel safe, whatever the internet might say. So if they come here and feel that they're being laughed at or made to feel like they're not a 'proper' cyclist because they wear a helmet or have the wrong bike or the wrong clothes, they may just say to hell with it and go back to using their cars... it's a thought.

Anyone want to be an improper cyclist? I'm thinking of starting a club ;-)

I love your sites but have disagreed with you on your helmet stance. The lifevest analogy though somehow pulls your argument together, rather neatly. Well done. I wear a helment and ensure my kids wear them too. After our rides I throw them in the pool without floatation devices even though thet would not be considered "strong" swimmers. Hmmm.

There is evidence that helmets provide "some" head protection, and I also like the fact that my helmet does a better job of keeping the sun off my pale pink head and glare and drizzle off of my eyeglasses while staying securely attached to my head and not flopping about like most other headgear does when I ride. I also ride in Detroit Michigan USA which is definitely NOT Copenhagen. Every little bit of protection I can get I'll take. If I lived in Copenhagen, or Groningen or some other cycle friendly European city I may feel less need for the helmet.

Americans are schizophrenic when it comes to risk. We idolize risk takers in business, art, athletics, politics, and even in academics. We reward them lavishly for their successes, and crucify them for their mistakes. However, helmet law advocates are aghast at the idea of individuals making risk evaluations when it comes to their own heads.

This dichotomy is lost on most of the the participants in the discussion. The arguments have become dogmatic on both sides, with few open minds. What is the use of protecting your brain if you are not going to use it?

We have to wear a helmet in Oz, and still do now that we are in the USA. My husband rode off without his helmet on the other day. He complained that he got even hotter than usual in the Californian sun. Maybe a hat would do the trick too but they don't stay on very well in a breeze. Also lycra? Very handy on a day of 30C+ when street clothes get soaking wet with sweat - even walking around makes one sweaty then.

When I started bicycling 30+ years ago there were no bicycle helmets in Europe (it was in Hungary where decent bicycles themselves were hart to get items). Later I lived in Germany. No helmets, no problem. Than I moved to Boston and my world has changed.

Warning! The text below may contain strong language. I will describe how people drive in the Boston area.

Bicycling (or driving for that matter) is no small adventure in Boston. Drivers are savage animals (70%), total morons (63%) and ignoranti (89% - not aware of the rules at all - you don't need to know all the rules master car handling to get a driver's license here). Some are outright stupid (45%). It is an offensive statement (which I do not want to extend to all folks on the road here) but the facts support my opinion. In which city do cars regularly and intentionally drive into an intersection that they have no chance of leaving before the light turns red? Yes, most of them do it here. Don't ask me the logic behind it - unless they are stupid. Where can you run red light in the presence of a police cruiser and get away with? Here. Witnessed that many times. In Boston "using the turn signal is a sign of weakness". In other places (in the US and elsewhere) it is the sign of carelessness and ignorance. How funny. On the bicycle you learn to read their "body language". When the car is at 10 degree angle to the right at the light it will turn right. When they slow down in the middle of the road they may turn either direction – be prepared. No one signals. When the Boston driver leaves from the curb side he/she hits the gas and steers the wheel slightly to the left. No looking back, no signaling. How do they park? In the middle of the road (and of course on the bike lane but that we don't even want to mention) where they have some business to do. There is parking 30 meters ahead? Not good enough. Park in front of the store or school or wherever you go.

I could go on with this through pages and pages. I ride in the city and on my road bikes out of town thousands of miles a year. The helmet saved my head twice and the lives (yes, yes, “scientist types”, - no controlled experiment here) of many of my biking friends. I only have some scars, 7 titanium screws and a plate in my right arm. Just to serve up a somewhat acceptable "control" to one of my helmet events: the impact contacts (the Roc-Loc points) on the helmet ripped off big patches of the hair from my head but no head injury. (OK, my wife thinks otherwise.)

Anyway, arguing against a bike helmet is easy in Europe where the driving habits (and the road quality) is not third world equivalent as it is in Boston.

When I saw the many-many cool bike riders in Berlin this summer (they wore no helmets). I did not worry much about them. The Germans know how to drive. But here in Boston you must have helmet.

I just had to vent my frustration with the drivers (and the cops) here in the Boston area.

Are compulsory helmet laws that bad? Bostonians are still upset (and "rebel" against) the mandatory seat belt wear. Of course, police officers here don't use them either. Remember the Resistance to helmets in pro bike races, like the Tour de France? Now all wear them and look good. Their hairdo may suffer, though.

Oh, come on. Anyone who would even argue a little bit against wearing a helmet has never met anyone who has had a serious head injury. It is a devastating event, and your life is permanently changed in an instant.

I let people make their own choices, but not wearing a helmet while riding a bike is a stupid choice, plain and simple.

When it all comes down to it, this issue may in the end really be a matter of liberty. Not giving people the choice to consider biking as something safe, instead forcing them use protective gear while using it do little good for making this activity more attractive. If you really feel the need to scare and reproach people with safety concerns, please don't start it with cycling. And this is where this science (so eagerly cited by zakka) comes in to play: we need cycling more than cycling needs helmets.

I'd like to make something else clear here: no one "helmet detractor" likes to see a law forbidding the use of protective headgear. (Even if this could actually raise the safety for some middle aged men in lycra, at least here in Sweden).

Also I'd like to point out a few things for all the very experienced cyclists who assert how many times their helmet saved them at their several crashes that, first of all, you don't seem to be a good role model for safe cycling. Second, you don't do much to promote cycling as a positive and safe activity. Third, I have a few advices for your safety, other than wearing helmets:

Keep your eyes open when ridingTry to ride more carefully/sensiblyUse helper wheels(I think I'll resist the urge to advice you against riding completely, considernig the matters being discussed here)

Concerning lycra, lycra clad cyclecommuters here in Stockholm are, generally, not very good promoters of cycling. Here one reason, although there are more: special cycle clothing of lycra seems expensive so people seem to be having just one set that they use for the whole week when cyclecommuting. Needless to say, sharing bike lanes with these cyclists is, in my experience, generally far from a pleasurable experience. Who said lycra did anything good against sweat?

Generic comment: yesterday morning a Giro Atmos helmet absorbed a big bang. As a result all the right side of my body is bruised, my jacket and tight are torn and everything hurts now like hell...but not the head. Think about this when you chose not to wear a helmet.

Firstly, I don't think taking advice from people who are prone to falling off bicycles is wise.

Secondly, a helmet is only designed to protect the head against non-life threatening injuries and, in rare instances, concussion so if you're saying that your head was spared these unlucky bumps, then fine.

But if you claim that it saved your life or other nonsense, how can you prove it? Did you reenact the accident exactly and fall identically without the helmet on to test both sides of the issue? If not, your anecdote is of little use. The science is against you.

But maybe you should concentrate on riding safely instead of falling off. Now THAT'S good advice.

I fell off my bike not too long ago. I attempted a fairly technical downhill that was too much for my skill. I was wearing a helmet, I was on my way home from work and my employer requires cyclists to wear helmets on their premises. (This is mostly the only reason I do wear one) Anyway, I was pretty concussed and lights out after the fall. And you know what? I still think the helmet made it worse. It brought my head almost 2 inches closer to the ground, and styrofoam is HARD, believe me.

Anyway, long story short, even after my fall, I think helmets should be worn by choice, not legislation.

I'm a cyclist in Australia where they have compulsion on helmets (and quite a bit of enforcement) for a long time. Sadly, it really did cause a lot of people, especially adults, to stop cycling when it was brought in.

There was no proper collection of statistics on cycling (a major policy implementation flaw!), but the data that is available indicates that adult cycling participation in a lot of states almost halved. Of course, it wasn't only because of helmet laws, cycling had already become a non-mainstream activity in general due to the rise of car culture and suburban sprawl.

Anyway, the number of trauma patients went down, so the medical doctors felt vindicated. But the lower participation rate meant that the risk of injury and death, for those who kept cycling went up. Hardly fair is it?

And the medical association that lobbied so succesfully never considered - I wonder how many people over the last 20 years in Australia suffered from heart attacks, or adult-onset diabetes because they no longer got regular gentle exercise from cycling?

Thanks for all the posts and info on this. I've just had someone tell me off for not wearing a helmet and bombarded tham with scientific evidence, a rundown of testing proceedures and helmet limitations. He said he'll look again and get back to me.

I fell tonight thanks to a dark section of one of London's so-called 'bicycle routes' channelling me at 30kph into an unpainted, unreflectored speed hump the size and shape of a slightly rounded kerbstone. Useless council c*&^*s!

Cracked the back of my mid-40s year old head right off the pavement with a rather alarming noise.

Wouldn't say it was fun, and certainly don't recommend it as a hobby, but just as after my 4 other similar incidents over 20+ years of urban cycling I remain firmly convinced that a helmet would have done little but cause nylon friction burns to my chin and face.

a helmet might have worsened the situation for you, according to studies, changing the linear forces of the impact into rotational forces - the ones that cause brain damage. And then there are the concerns about neck injuries caused by helmets - a rather neglected area of research.

I'm also fervently against mandatory helmet legislation and I do believe that it would cause people to bicycle less, which is probably worse than the individual gains made by wearing a helmet.

BUT

I think it's ridiculous to refer to advocacy groups like cyclehelmets.org and present them as 'scientific' researchers, when it's simply impossible to run an authentic experimental study on helmet safety. It's one to thing to allow people the right to choose, it's another thing to twist reason to cause people to think that helmets are HARMFUL. The available evidence simply does not support this assertion.

I should also add that my country-women and men might find it strange to hear stories about people falling off their bikes and hitting their heads, but before you judge, remember that not every country has such an enlightened bicycle culture and infrastructure as Denmark does.

Take a Danish cyclist and put him in a town like New York or Toronto and suddenly wearing a helmet may not seem like such a bad idea.

It's difficult to define "The available evidence", isn't it? There are over 100 studies on the subject. When you cull the crappy science, you are left with 'available evidence' that helmets do not save lives, that they are not even designed to do so and that they do not reduce head injury levels.

Indeed, there are many studies that show that helmets are, in fact, more dangerous. Increased risk of rotational injuries, increased risk of just hitting your head because it's bigger, risk compensation, etc.

Being acquainted with a number of the cyclehelmets.org people personally, I see doctors, scientists and bicycle advocates wanting to increase cycling levels.

The amount of pro-helmet studies that twist facts - and that are subsidised by the helmet industry - far outweighs the twist-factor in studies that are pro-cycling and helmet sceptic.

Respectfully, I disagree. In fact, in my view, cyclehelmets.org are skewing the facts to the disadvantage of people who really want an objective, neutral survey of the available evidence.

A quick example, their primary graph on the main page (which you've also used) is a perfect example of what's known as a spurious correlation, and it shows the bad faith of those on the anti-helmet side. The fact is, infrastructure and bicycle culture matters (which you'd likely agree with), so of course bicycling fatalities are lower in countries such as Denmark and Holland. A proper comparison would require two countries with identical infrastructure and bicycling laws/culture, with one having higher helmet use than the other. I don't know any scientist or doctor that would ever take that graph seriously.

Another telling sign - cyclehelmet.org's 'for' helmet effectiveness page has no articles after 1998, while their 'against' page has articles right into 2008. The simple fact of the matter is that if they had updated the 'for' page until the current year, the weight of materials would be sharply skewed in favour of the 'for' side of the argument.

That's just one of the few examples of how leading anti-helmet advocates are using bunk statistics and sneaky tactics to present a completely biased and unscientific standpoint.

I think we can be against mandatory helmet legislation without adding to an already irrational hatred of helmets.

Interesting, Sune. The Dept. of Transport in the UK did an analysis of a large portion of studies from both sides of the argument in order to somehow find a way through the maze. Their sober results go against your opinion.

They also point out that the For side is comprised mainly of people from the medical profession whilst the Against side is a wider array of professionals, including scientists, researchers, doctors and bicycle advocates.

There were more studies against than for and many of the 'for' were the same people reworking old data. They focus soley on stats regarding head injuries vs. helmet use whilst those against use a broad range of science including the benefits of cycling vs lifestyle illnesses, risk compensation, the science of helmets, etc.

The report recognizes that the debate is bitter and nobody is budging, which is often true. However, it underlines that there is no conclusive evidence that helmets do any good.

In fact, there is nowhere in the world where promotion and/or compulsion has reduced head injuries. Rather telling.

Your response is rather telling actually (I promise to stop using that word after this!), it shows that you've selectively read that report - "Road Safety Report #30"

The findings were indeed clear, and here's the summary: http://www.dft.gov.uk/pgr/roadsafety/research/rsrr/theme1/bicyclehelmetsreviewofeffect4726?page=3#a1004

There is perhaps one bullet point that vaguely supports your argument: "While most studies indicate that helmets offer protection from head injury, the relative risk of injury in helmeted and unhelmeted bicyclists has varied in different studies."

It can be easily misinterpreted - it states that the results of RELATIVE risk have varied from study to study, which is to be expected.

What's more important, however, are the preceding points:

# Bicycle helmets have been found to be effective at reducing the incidence and severity of head, brain and upper facial injury.

# Bicycle helmets have been found to be effective in reducing injury for users of all ages, though particularly for children.

Also, with regards to both sides of the debate, what the report states is that the sides are speaking past one another. The Against side doesn't address the protection from injury directly, but rather focuses on what I would call 'softer' issues, such as risk compensation (a dubious claim - as a psychologist, I've seen evidence that counters this 'common sense' view), compulsory helmet legislation leading to reductions in bicyclists (again, a separate issue); whereas the For side seems to ignore these issues, thinking that scientific evidence for head injury reduction should stand on its own.

It concludes: "The way in which the debate has been conducted is unhelpful to those wishing to make a balanced judgement on the issue."

Again, there's a misinterpretation of Brian Walker's words here. Even in the articles on cyclehelmet.org (and I am unable to find an original version of this document so I'm going with the cyclehelmet.org version), Walker has never claimed that helmets don't work at all.

He's referring more specifically to an unfortunate watering down of helmet standards by the EU. Standards are different between countries or regions(the Catlike Kompact for example, was (is?) not available for sale in the US, despite it's popularity). Do these matter? Well I would think so, but the same Dept. of Transport research paper you reference to support your argument, states:"There is little evidence that helmets of different standards perform better in protecting the wearer". This contradicts Walker's assertion that better standards are needed.

Second, he never states that EN1078-compliant helmets are useless or advocates that one shouldn't wear a helmet at all, and in this specific article (http://www.cyclehelmets.org/1081.html) he contradicts the UK High Court's finding: "My purpose is not to dissuade people who wish to, from wearing cycle helmets. They do, I promise, work a little better against a flat surface, than the Court decided in the case I cited above."

I admit, he's skeptical of the current spate of helmets on the EU market, but if you really agreed with his stance, you should be advocating for better standards in helmet construction.

Instead, you're saying helmets are both useless, and even sometimes harmful to the wearer, which outweighs any potential benefits. Sorry, but I can find no serious evidence supporting that stance.

The situation is not quite that the right to helmeted cycling is under constant growing pressure, fervently contested using simplistic, cheap cliché's...

But after all, cycling is such a negligible, insignificant issue. Which is the reason why the introduction of new legislations criminalising cycling without protective gear have been rather sluggish (with some exceptions). Despite all the efforts.Not to mention how sluggish it is (or would be) to revert such legislations once passed, if for instance bike sharing programs are to become successful.

But what if cycling is to be taken seriously? (No I don't mean by chasing grams and seconds.) But perhaps by caring for the needs of those who chose to cycle for transport and maybe even having more people to do that.Trying to come with a definitive answer here would not be very scientific, of course. However, considering available science on the subject it would be reasonable to conclude that that type of legislation should be avoided. Even more so if we wan't to promote cycling as something safe and healthy.

I grew up in Amsterdam, been cycling since I could walk and never used a helmet,and do not know anyone that did.I moved to the U.K. and went of my bike twice. First time I ended up in hospital and had more than 40 stitches on the top of my head.Did not look nice I can tell you that.Second time got knocked of by a car, ended up in hospital again, broke a rib etc,and cracked my helmet instead of my skull, because this time I was wearing a HELMET. I am sure I would not have been here if I had not used a helmet.I am after three months recovering back on my bike, but would never go without a helmet.

I have had four crashes on my bikes, (2 mountain and 2 on the road) where my helmet appeared to do what it was designed to do. The impact area was compressed and showed some cracks. In one incident the helmet split apart. The one accident where I a feel the helmet probably saved my life was one where I was T-boned by a pick up truck accelerating to about 40MPH. The impact broke the cleats holding my feet into the pedals and I flew "Superman" style about 20 feet. The first thing to hit the ground was the front of my helmet. Sure, I suppose that if I was not wearing a helmet I may not have suffered any injury to my head as some of these "scientific" studies are claiming, but I sure as hell don't want to test that hypothesis!! As it was, I walked away from the crash with very little injury although my entire body hurt for about two weeks. Taht said, I think each person should make the choice, not the government. Here in the US, a helmet makes sense to me.

I don't keep falling off of my bike, irresponsible drivers keep breaking laws and hitting me! As for mountain biking, I will admit to not being the best, so in that area feel free to disregard any advice I might offer :)

B. I wear a bicycle helmet to reduce annoying head injuries, not to prevent fatalities. I've hit my head several times, nothing that would strike a fatal blow or even crack the helmet but still scratched it up pretty good. That and I used to live in Australia, where the police have nothing better to do than harrass people without helmets.

Where I live, in Canada, helmets are mandatory. I refuse to wear one, and if I am ticketed for non-compliance, I plan to fight to the bitter end to have the law overturned. After 38 years of riding, I can say that I have never bumped my head a single time in a bike crash. I used to crash regularly as a kid, trying to do stunts like jumping fences and snowbanks,yet never once bumped my head.I have never crashed as an adult. I believe that I know how to fall to protect myself, and yes, I have flown through the air like Superman, but as a pedestrian,after being struck by a drunk driver, and I still did not bump my head. Nowadays, I am too cautious to let my bicycle go really fast down long steep hills (because I am aware of my vulnerability),and I suspect in another ten or fifteen years I may start wearing a snow-board style bike helmet if I feel less capable of controlling a fall. I believe that our government has over-stepped their authority, and infringed on my personal rights and freedoms with the helmet law. On the other hand, I will never ride a motorcycle without a helmet because the speed involved increases the possible crash forces drastically, and as a motor-vehicle I am under the authority of the motor vehicle department of the government, requiring license and insurance while riding the motorcycle. I have many friends that have never bothered to ride a bicycle again, since the helmet law came into effect. It really did reduce the number of riders here,and also forced some, such as myself, to become "outlaws". I don't think there is anything wrong with wearing a helmet if you choose, but it must be a choice. Personally, I don't like the common helmets with the pointed tail. There seems to be some concern that they do increase neck injuries compared to a "less-sexy", round, city-style helmet. So far, the local police don't seem to be concerned about the lack of helmets. I'm hoping that attitude doesn't change!

are helmets a good idea? yeah. i have one....but i hardly ever wear it. as someone else said, if you're going somewhere on a bike (as opposed to going for a bike ride), what do you do with the helmet once you get there?

besides, the places i ride that i'm most concerned about actually getting hit by a car, the cars are traveling 55 mph. IF i were hit, i could easily be killed without a head injury. as to other more "minor" accidents i may get in, i hurt myself all the time and i'm usually really good at catching myself, so i'm not very worried about a "serious" injury. a helmet won't stop a broken wrist.

btw - a head-on collision with another cyclist hurts. a lot. *hehe*

definatly B - although i would support laws requiring young cyclists to wear helmets. your average 6 year old isn't going to be very cautious about watching for traffic, other cyclists, curbs, and whatever other obstacles they may encounter on their way to a friends house or school.

I'm living in Melbourne, Australia, where a disturbing number of motorists seem to be of the view "I pay my rego, get off my road, or I'll run you off!" (roads are paid for by taxes, rego is a compulsory car registration cost that is split between "registration fee" [i.e. admin], transport accident charge, and 3rd party insurance). I wear a helmet, mostly out of habit, partly because it makes me feel safer on the roads here. I haven't had an accident (yet), because I ride with the view that all motorists are unobservant morons who are trying to kill me (I believe the polite term is 'defensive riding'). When on holiday in Amsterdam, I didn't wear a helmet, and felt fine with that - in Amsterdam I did not feel like anyone was trying to kill me!

So, I continue to wear my helmet here, and when I get to where I'm going, I slot it onto my bike lock and leave it with my bike.

As far as legislation goes - helmet use should not be mandatory. Government should be providing infrastructure such that cycling without helmets is perfectly safe, and should also be acting to cause a culture shift towards people viewing cycling as a normal everyday activity (like Amsterdam, Copenhagen etc), and actually respecting cyclists. More cyclists means more cyclist safety, and if removing helmet laws, leaving helmet use to personal choice, increases cyclists, that's good with me.

ps not *all* motorists here are actually unobservant morons who are out to get me, it's just it's safer for me if I ride with that assumption. Some are actually very good, very observant, and make sure they give enough space when overtaking, stay out of bike lanes, check mirrors plenty, signal well before manoeuvring etc. These are the ones I would like to clone :-)

craig, wishing other people to be hurt is hardly a civilised approach. if you don't like science and facts, that's your choice. a strange choice, but yours all the same. me, i prefer knowing things to merely believing in things.

Hi, I ride in Australia and have a helmet, becuase I have to have one to be legal. There were studies done in Melbourne, where I used to live. When they introduced helmets the number of people who rode bikes went down dramatically. The Australian Cycling Federation did a study. There was no statistically significant change in the type or number of head injuries sustained by cyclists before and after the change. They used the hospital statistics for this study for two years before and two years after the helmet laws were introduced.

There is a wearable air bag vest now being promoted in equestrian sports. Will some cyclists be promulgating these as well? How about full ice hockey goalie suits. Where does it end? I rode horse all my life without a helmet, road motorcycles for 25 years, worked in a hospital ER for 6 years. I will never choose a helmet for my bike, even if I can't join their little club rides. Sick of pretentious power rangers.

It seems like I'm the only one arguing this, but I disagree wholeheartedly with the author on this one. Using a helmet can only serve to make you more safe while riding. I understand that copenhagen has a much better cycling infrastructure and that injuries are only a fraction of what is seen in the united states. Fine; A helmet may be less useful when you have a wonderful infrastructure. Cyclists in the US are also more often forced to share the road with cars, forcing us to move at faster speeds (~20mph/30kph), compounding the risk of injury.But to argue that 'oppressive' helmet laws are hindering bike progress is utterly ridiculous. US lawmakers postpone bike infrasturcture because they don't view it as legitimate. It has nothing to do with helmets. The issue needs to be addressed at the legislative level.Secondly, to argue that buying a helmet somehow prevents people from riding is once again a poor attempt to deride helmets. If you've decided to commute to work or ride as a hobby, a 25 USD helmet is going to be the last thing stopping you. Finally, the most unconscionable aspect about this argument is the potential harm you're invoking by pretending riders should go without helmets. Studies done within the US show that helmets are 90% effective at preventing closed head injury and 88% effective at preventing traumatic brain injury. These are potentially life-altering injuries and they are nearly always prevented by helmets. How much do you think helmet use really hinders bike riding? And how? Will you one day decide not to ride because you have to go through the menial task of putting on a helmet? I doubt it. I see no downsides to helmet use. If one cyclist is saved by her decision to wear a helmet, that is a success.

Studies indicate that bike helmets are minimally effective and only at low speeds. And of course there is the rest of the body that is also vulnerable in an accident. There was a recent and thorough summary in Mountain Bike magazine, which you can evaluate for yourself. It is the image of the angry rider of a bicycle, gritting his teeth, hunched forward and rude that is keeping biking from seeming normal and appealing to more people as an easy, quick way to run errands or get from A to B. The negative perception triggers hostility by car drivers who then become a larger part of the problem.Helmets are not the answer. If you're not part of the solution, you're part of the problem.

Kilometres cycled by Copenhageners so far today

Copenhagenize.com is the blog of Copenhagenize Design Company. Online since 2007 and highlighting the cycling life in Copenhagen and around the world.

40 years ago Copenhagen was just as car-clogged as anywhere else but now 41% of the population arriving at work or education do so on bicycles, from all over the Metro area. 55% of Copenhageners themselves use bicycles each day. They all use over 1000 km of bicycle lanes in Greater Copenhagen for their journeys. Copenhagenizing is possible anywhere.